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Assisted Living Shopping

Our parenting columnist struggles with the epic challenge of convincing her parents to move to an assisted living home.

My brother and I started visiting assisted living homes for our parents, 80 and 85.

Dad falls once or twice a month now and can’t get up. The local firefighters have to come and get him upright.

My mom forgets things. She gets confused. Making a sandwich these days is a challenge. She forgets to turn the burner off when cooking.

They live independently right now in the mountains, three hours away in Arnold.

Snow is coming. We need to get them out before winter, but they don’t want to leave.

Dad is especially adamant. “I’m going to die soon anyway. Just leave us alone. We’re fine.”

We want to move them before something does happen to dad, so mom will have friends and caregivers to look out for her. We want them to be closer to us, so we can visit them more often and they can see their grandchildren.

My brother and I visited several assisted living homes in San Ramon and Danville these past few weeks.

My friend Charles advised me to be careful about the larger homes. They tend to escalate fees. They charge $2,500 or more a month per parent but tack on added fees for everything from medication management to answering a parent’s call late at night.

The smaller homes, we’ve discovered, offer all these services for one, flat rate. Plus they’re homier, less institutional.

Another friend, who used to own a small, assisted living facility, said a lot of his residents came from larger homes that had nickel-and-dimed them up the yin yang.

I’m grateful to these friends for guiding us in this most daunting and heart-wrenching task.

But no one so far can adequately help us with the hardest part of this ordeal: How do we get our parents to agree to move?

Some say lie. Tell them it’s just for the winter or that it’s just for rehabilitation. That seems wrong.

But telling the truth doesn’t seem right either. “Look, you guys can’t take care of yourselves anymore.” No, that could never be said.

Thankfully for me, it’s my brother who gets to have this most delicate conversation. I trust he’ll find the right words when the time comes… tomorrow.

Lately, we’ve been taking turns transporting our parents to doctor appointments they’ve stopped making for themselves.

Each trip requires we take a day off work. And they need more and more doctor appointments.

We started visiting potential homes for them a few weeks ago. The first home in Danville was a larger facility. Beautiful, like a four-star hotel.

As we walked through the door, an elderly woman, who looked about 100 years old, sat hunched over in a chair, staring blankly. We smiled, said hi. No response.

I tried to imagine how my parents might feel walking through those doors. Will they see it as a prison?

Will they hate us for moving them there?

Assisted living homes provide regular meals, safety, transportation to doctors, the promise of socialization and activities.

But will our parents appreciate these benefits? Or will they feel like unwanted toys left in a box by the curb?

Even if we can miraculously convince our parents to move, the sticker shock alone might kill them.

It will cost between $5,000 and $6,000 a month to keep my parents safe. To pay for that, we’ll have to rent out the home they live in now (presuming they’ll agree to that) or sell it (if they can in a down market) and take a steep loss.

On the bright side, a few of the elderly people we met in these homes seemed downright chipper.

We met a woman who declared, “I’m 100 years old. I was born the same age as Hitler and I’m having a hard time with that.”

When I’m 100, I hope I end up with someone like her as my roomie.

Philip Leech October 27, 2011 at 07:07 PM
Have you thought about taking care of them yourself? It would be the most difficult job you ever had, but also the most rewarding.
Penny October 27, 2011 at 07:37 PM
I am an elder myself, and had such a hard time with my mom, ending up with her getting embezzled when I was unable to keep better tracking of her,(I lived 1.5 hours way and my husband had just passed away).She lived in her own home with a care-taker. She had refused to consider a move closer to me. I decided to do it better for my kids. Make them part of the process; show them the homes and also contact agencies that specialize in that kind of help for people like you. The Council on Aging. or the Agency on Aging, I believe it is called; it is federal but with local offices.. Google it.
Sherry Rosso October 28, 2011 at 11:13 PM
Had you read Jennifer Wadsworth's "City for All Ages" article on Aug. 24th? It raised some interesting topics, but, sadly, no one except me responded. As a veteran "parent" to both my parents, having had a parent (or both) in assisted living and skilled nursing care for the past 23 continuous years, in three different states, I know a little bit about the topic, all its ups and downs. Both my parents had quite tragic and unusual circumstances that derailed their health at young ages. I'm the responsible party for my mom, for the past decade, and she lives in Alameda County. When I moved her here from a facility in Idaho, I put her on wait lists for SNF's that I liked. That fancy hotel you speak of - I bet its probably the one near Bettancourt Ranch. Mom's been on that wait list since the fall of 2004. As a SNF patient, she'll never get in - the list is so long, and there are hardly any beds. I put her on a wait list at a small facility in downtown Pleasanton - again she's been on it since 2004. She was able to find a spot in a small facility in Castro Valley, thank goodness, and has been there nearly seven years. Assisted living is easier to get into because all the corporations make all or most of their beds for that purpose: yes, it costs an awful lot of money! Most of the patients in assisted living graduate to advanced care quickly, and if their family can pay, great, because generally these facilities are so much nicer.
Sherry Rosso October 28, 2011 at 11:29 PM
But, when I say nicer, I say this only about the decor, the ambiance, how much better they make the patient and family feel about moving in there. Somehow, it seems more palatable. However, the care at any facility, small, large, fancy and corporate, or dated and homey, is only as good as it's staff and management. You want to get a really good feeling for the CNA and nursing staff - talk to a number of them extensively before choosing. Go to the areas where they take their breaks - is there an outdoor garden area or lounge where you can meet the CNA's? They are the ones doing all the care for your loved one. They help feed them, change them, wash them, bathe them, and converse with them, and they are the ones who need patience to put up with the difficult job they have. They need to have the patience and the desire to keep on smiling and encouraging your loved ones in all their struggles. I have a cousin on the Peninsula who is caring for his father, whom he put in an assisted living facilily after he suffered a stroke and could no longer be safe to live on his own. Its been a few years now, and though my cousin has rented out his father's house to help pay the cost of the facility, he is finding it very expensive to pay the huge differential each month for such a long period of time.
Sherry Rosso October 28, 2011 at 11:37 PM
We do need more facilities in the Tri-Valley area, and they need to be more affordable, somehow, for families. Boomers thought they'd rely on the equity in their homes to cover such expenses, but many are losing their homes, or have no equity, as they took it all out, and values are lower now. Seniors could move in with their grown children, but in many circumstances, when the senior is bedridden and has advanced medical issues or even care needs (think changing their Depends 4 to 5 times a day), can the adult be around enough to properly care for their parent if they work full or part time and/or are raising children themselves? That becomes a lifestyle of caregiving, with no breaks for the caregiver whatsoever, for an undefinable time. No one likes to think about these issues - but its important to think about the "what ifs" so you are not blindsided when you are forced to deal with these issues - for your parents, or for yourself.
Julie Knight November 23, 2011 at 09:05 AM
Thank you, Sherry, for such a thoughtful response to my article. I apologize for taking so long to respond - I didn't see this before. My parents refused to move so we found an agency that will send caregivers to their home. It's a first step. We wished they would to a facility near us, but my dad is especially stubborn and he calls the shots. Sounds like you could write a book with all the info you've learned on this subject. Thank you so much for sharing your experience. Julie
Penny November 23, 2011 at 04:21 PM
You asked the question, how do you present the subject to them in a way that they will be more likely to accept. I was wondering if their doctor might be willing to discuss their safety with them and how they might be more safe in a living situation closer to you too. My mom was more receptive to opinions of "professionals" than she was to me, even though my work involved just the kind of thing that they were facing. She was willing to hear things from the doctor or her lawyer more than me.. So that might be worth a try.
Sherry Rosso November 28, 2011 at 08:27 PM
Penny's advice - about having a health professional your parents trust talk to them about a safer living situation - is good. So often, we need to hear advice from someone who is not so close to us. I'm glad you were able to get your parents to accept caregivers. People often want to remain in their homes, and independent, as long as they can. If your parents' caregivers can frequently inform you of what they find, and how your parents are managing day to day, you'll be in a very good position to assess when it is most critical to get them into another living situation.

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